Nutrition and lifestyle habits in early childhood may be key to supporting healthy growth. The Nutrition Screening Tool for Every Preschooler (NutriSTEP®), a validated screening questionnaire for preschool nutrition risk, was implemented in two community health centres. Study objectives were to identify the proportion of children at nutrition risk and to assess acceptance and impact of dietitian referrals.Parents attending preschool immunization clinics were asked to complete a consent form, NutriSTEP®, and a parent questionnaire to gather demographics and perceptions of NutriSTEP®. Follow-up counselling by a dietitian was offered for parents of high-risk children, and parents who attended completed a follow-up questionnaire.Seven percent of the children screened were at high risk. Almost 50% of parents reported adverse feeding environment behaviours. When a parent's reported daily frequency of a child's consumption was used as a proxy for daily servings, the majority of children fell short in most food groups. Thirty-three percent of 30 parents of high-risk children completed dietitian counselling. Most parents (75%, n=6) who were counselled reported making changes as a result of counselling and were satisfied with the service (63%).NutriSTEP® was an effective tool for identifying preschool children at risk. Although few parents accepted referral to a pediatric dietitian, most who did made changes to improve nutrition and lifestyle risk factors.